NAD⁺ — Research Dossier
Evidence grading
Age-related decline
Multi-tissue
Documented in skin, blood, liver, muscle, brain
Precursor effect (NR/NMN)
~2×
Circulating NAD⁺ increase over ~14 days in RCTs
Human endpoints
Surrogate-led
NAD⁺ levels measured; hard outcomes limited
Injectable NAD⁺ RCTs
Limited
Most evidence is for oral precursors only
NAD⁺ is one of the most fundamental molecules in metabolism, and its decline with age is well documented. The nuance the marketing usually skips: most human trial evidence is about precursors raising NAD⁺ levels, not injectable NAD⁺ or hard clinical outcomes.
Nicotinamide adenine dinucleotide (NAD⁺) is an essential coenzyme central to energy metabolism, DNA repair, mitochondrial function, and sirtuin signalling. Intracellular NAD⁺ declines with age across multiple tissues, and restoring it improves cellular and physiological function in numerous model systems — the rationale behind interest in NAD⁺ boosting.
“Chronic NR supplementation was well tolerated and raised NAD⁺ in healthy middle-aged and older adults, with an early signal for reduced blood pressure and arterial stiffness.”
— Martens CR et al., Nat Commun 2018
The human evidence — precursors and surrogate endpoints
Most controlled human data concern oral precursors — nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) — rather than NAD⁺ itself:
- Martens and colleagues (Nat Commun, 2018) reported that chronic NR supplementation was well tolerated and raised blood NAD⁺ in healthy middle-aged and older adults, with an early signal for reduced blood pressure and arterial stiffness.
- A randomised trial of NMN in older men (npj Aging, 2022) raised blood NAD⁺ and altered measures of muscle function.
- Yoshino and colleagues (Science, 2021) reported improved insulin sensitivity with NMN in prediabetic postmenopausal women.
- A head-to-head comparison found NR and NMN roughly doubled circulating NAD⁺ over 14 days, while nicotinamide did not.
These endpoints are largely the surrogate of raising NAD⁺ levels rather than hard clinical outcomes, and they test oral precursors. Direct controlled-outcome evidence for injectable NAD⁺ is limited; larger trials in neurodegeneration and metabolic disease are underway.
What the data establishes and does not establish
The strong basic science establishes NAD⁺'s biological importance, not a proven clinical benefit of supplementing or injecting it. Precursor trials have consistently shown that oral NR and NMN raise circulating NAD⁺ — but whether this translates to meaningful clinical outcomes remains an open question. Studies testing hard endpoints in defined patient populations are ongoing.
NAD⁺ is an endogenous coenzyme, not an approved therapeutic. Precursors such as NR and NMN are sold as dietary supplements in many jurisdictions without regulatory approval for any indication.
What this evidence is — and isn’t
These trials studied pharmaceutical-grade NAD⁺ administered under medical supervision in controlled settings. The figures summarised in this dossier describe that published science only.
They are not outcomes associated with research-grade material, and not results attributable to any use of the product sold in this catalogue. Nothing here is an endorsement, recommendation, or instruction for human use.
Nexyra Lab Catalogue
This dossier covers published clinical research on NAD⁺. Nexyra Lab supplies research-grade NAD⁺ for in vitro laboratory use.
View NAD⁺ in the Nexyra catalogue (research use only) →See also
References
- 1
Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD⁺ in healthy middle-aged and older adults. Nat Commun. 2018.
- 2
Authors not yet confirmed — owner to update. Chronic NMN supplementation elevates blood NAD⁺ and alters muscle function in healthy older men. npj Aging. 2022.
- 3
Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021.
- 4
Authors not yet confirmed — owner to update. Clinical evidence for the use of NAD⁺ precursors to slow aging. Not yet confirmed — owner to update. 2025.
Research & Laboratory Use Only
This dossier is compiled for research planning and educational purposes only. It summarises published scientific literature and does not constitute medical advice, dosing guidance, or a therapeutic claim. All Nexyra Lab products are for research purposes only and are not for human or veterinary use. Nothing in this document should be interpreted as recommending, endorsing, or facilitating the self-administration of any compound.
A one-time legal review of this template and disclaimer is recommended before the Journal section is made publicly accessible, given the health-adjacent nature of this content.